1. Systems Analysis of a Dedicated Ambulatory Respiratory Unit for Seeing and Ensuring Follow-up of Patients With COVID-19 Symptoms
- Author
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Hans Kim, Tze Sheng Yap, Mark D. Aronson, Kashika Goyal, Timothy S. Anderson, Tiantian White, Russell S. Phillips, James C. Benneyan, Nicole Nehls, Marc Cohen, Julia Lindenberg, Gordon D. Schiff, and Scot B. Sternberg
- Subjects
Adult ,Male ,Systems Analysis ,Pneumonia, Viral ,education ,Staffing ,Ambulatory Care Facilities ,Workflow ,Unit (housing) ,Documentation ,Phone ,Humans ,Medicine ,Respiratory Care Units ,Referral and Consultation ,Aged ,systems engineering ,SARS-CoV-2 ,business.industry ,Health Policy ,COVID-19 ,symptom follow-up ,Original Articles ,Continuity of Patient Care ,Middle Aged ,medicine.disease ,Gatekeeping ,Ambulatory ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,Female ,Medical emergency ,business ,Boston - Abstract
Supplemental Digital Content is Available in the Text., COVID-19 necessitated significant care redesign, including new ambulatory workflows to handle surge volumes, protect patients and staff, and ensure timely reliable care. Opportunities also exist to harvest lessons from workflow innovations to benefit routine care. We describe a dedicated COVID-19 ambulatory unit for closing testing and follow-up loops characterized by standardized workflows and electronic communication, documentation, and order placement. More than 85% of follow-ups were completed within 24 hours, with no observed staff, nor patient infections associated with unit operations. Identified issues include role confusion, staffing and gatekeeping bottlenecks, and patient reluctance to visit in person or discuss concerns with phone screeners.
- Published
- 2021
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